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Going through a traumatic event can be life changing, often leaving individuals feeling devastated and alone. A trauma is defined as an event or threat that causes you to feel in danger of serious physical harm. This includes near death experiences, sexual assault, domestic violence, accidents, child abuse or even being a witness to a crime! Experiencing a trauma can cause significant impairments and in emotional, psychological and social functioning. As more research becomes available about the impact that trauma can have on emotional health, it has become clear that effective treatment is vital and can have a significant positive impact on improving overall well being.

Symptoms of trauma include:

Recurrent and unwanted memories of the trauma

Flashbacks and/or nightmares

Severe emotional distress or physical reactions to reminders of the event

Avoiding places, people or reminders related to the trauma

Low self-esteem, shame and guilt

Feeling numb or hopeless

Isolation and losing interest in activities that once were pleasurable

Memory problems

Irritability

Substance abuse

Hypersensitivity to sounds and ones environment

Trouble concentrating

Trouble in interpersonal relationships

Disassociation

Often when working with clients, I hear a theme of profound struggle and pain that comes from living with these symptoms. The impairments caused by experiencing trauma can be emotionally draining and at times feel hopeless. It is important to remember that these responses are, “normal reactions to an abnormal event.” Many people become flooded with feelings of guilt and shame following a trauma and hide their symptoms in fear of judgment from others. This makes it even more important that we address the stigma surrounding mental health and become we become educated about the impact that untreated trauma can have. There is a clear link that has been found between substance abuse, eating disorders, self-harm, suicide and trauma.

Trauma can also impact relationships and leave individuals feeling alone and isolated at a time when connection to others is needed most. Leading to co-occurring depression, anxiety or other mental health issues. Research has found that talking about the trauma with a safe and trustworthy person can actually decrease and even eliminate symptoms. Taking the first step is difficult; but life changing!

A woman tells her friends before her date that she plans to have sex with her boyfriend that night. He is taking her to a campus party, and she dresses in a very skimpy halter top, short skirt, and heels. To get ready for the date, she takes several shots before the night begins. When she arrives at the party, she proceeds to consume many more alcoholic beverages, as well as an ecstasy pill, and asks her date to take her to his room. She initiates kissing and takes off her clothes. Her date follows her lead and the couple begin making out on his bed. After a few minutes, however, the woman changes her mind about sleeping with her date. He inserts his penis, and she tells him that maybe they should slow down. He says, “Come on, I know you want me too.” Her body has become physically aroused. She says, “No,” but does not physically attempt to stop him. Tears roll down her cheeks, and she feels defeated.

Many of us have heard stories such as these and some may have even made judgments about the rape victim. Those judgments are called rape myths. Rape myths are defined as false beliefs about rape, which are influenced by the individual’s prejudices and sexist beliefs (Burt, 1980; Lonsway & Fitzgerald, 1994; Ullman, 2010). It is important to abandon rape myths because they serve to ignore and justify male sexual assaults against women (Lonsway & Fitzgerald, 1994). Examples of rape myths people may believe about the example above are:

 Rape myths
• It is not really rape if the victim has previously had sex with the perpetrator
• If a woman originally consents to sex, it is not rape

 In fact
• Consent must be given during each sexual encounter
• California Law states that consent can be revoked at any time, including after penetration (California State University Los Angeles University Police, 2012)

Belief in rape myths hinders victims from seeking out resources after being raped (Fisher et al., 2000; Hayes-Smith & Levett, 2010; Norris & Cubbins; 1992; Olson, 2004; Ullman, 2010). In reality, it is not the victim’s fault even if she: was drinking, using drugs, going out alone, talking to strangers, staying out late. If a victim blames herself for the rape, then she is less likely to seek legal ramifications for the attack, which in turn means that the perpetrator will not be punished, and may continue to assault other women.

Many couples enter therapy for the first time hoping that they will learn better ways to communicate and their relationships will improve. A “common complaint made by couples is that the communication between them has eroded or at least negatively changed over time” (Mahafeey, 2010 p. 45). Healthy communication between couples has a high correlation with satisfaction and happiness in the relationship. Research has found that “lack of communication, distressed communication, and negative communication have all been linked to couple distress…conflict, and psychological distance within the relationship” (Mark & Jozkowski, 2013, p. 414).

Leading researcher in couples counseling John Gottman (1999) proposed that relationship satisfaction is not dependent on whether a couple fights but rather how they fight. In his research, Gottman found that couples that reported being happy and satisfied with their relationships have a five-to-one ratio of positive interactions for every negative interaction (Gottman & Silver, 1999). Therefore, one of the goals of therapy should be to help couples change destructive conflicts into constructive and reparative communications opportunities.

Gottman discovered that couples that reported being less satisfied with their marriage, often began their discussions with “harsh start-ups” such as, criticism of the partner or sarcastic remarks. He also observed that these couples had more criticism, contempt, defensiveness and stonewalling during their interactions. The negative interactions became known as the “four horsemen of the apocalypse” (p. 27). Through his research on couples he has been able to predict with 97.5% accuracy the longitudinal course of relationships (Gehart, 2013).

The Four Horsemen

The presence of the four horsemen during an interaction between couples can predict divorce with 85% accuracy (Gottman, 1999). The four horsemen are: a) criticism, b) contempt, c) defensiveness, and d) stonewalling. Criticism is a statement that attacks character and implies that there is something inherently wrong with the partner (e.g. “you always do everything wrong”). Contempt is expressed when one partner sees themselves as superior to the other (e.g. “you don’t deserve to be with me”). Defensiveness is protecting oneself from attacks by the partner (e.g. “This is all your fault… You always mess everything up”). Stonewalling is withdrawing from the interaction emotionally, mentally, or physically (Gehart, 2013, p. 302). Flooding, or the feeling that a partner’s negativity is so overwhelming that it leaves the other shell shocked, also was a common element discovered in couples that reported being dissatisfied in their relationship. Finally, the greatest predictor of divorce that Gottman found was failed repair attempts. Failed repair attempts are “efforts that a couple makes to deescalate the tension during a touchy discussion” and in “unhappy marriages… [It is] harder to hear and respond to a repair” (Gottman, p. 40). Therefore, distressed couples have more attempts at repair then happy couples because these attempts are unsuccessful at ending or deescalating the argument.

Communication between couples is an important factor in determining each partner’s satisfaction in the relationship and is linked tightly to relationship outcomes (Johnson & Bradley, 2009). Being able to communicate in a calm and respectful way can help couples learn healthy ways to handle conflict and improve their relationship. Couples therapy can help couples learn these tools and has been found to be highly effective in decreasing the “likelihood of divorce and improving individual and family well-being” (Tambling, Wong & Anderson, 2014, p. 29).

If you are interested in reading more about John Gottman’s research you can check out his book: The Seven Principles for Making Marriage Work.

** This blog is an excerpt of an academic paper written by Sandra Kushnir, MFTI. 85116

Experiencing a traumatic event is more common than most people think. However, there are several common misconceptions about living with trauma. It can be hard for people who have survived a traumatic event, and for people who seek to be supportive to survivors, to understand why their mind and body reacts as it does. Here are seven common myths about living with trauma.

Myth #1: You have to be physically hurt to experience trauma

Trauma results from an experience of intense fear (American Psychiatric Association, 2013). Physical violence may have occurred but it may not have. Trauma can occur when the person feels like their life is in danger or when their sense of safety is threatened.

About 8% of the American population will develop PTSD in their lifetime (Kessler et al., 2005). However, PTSD can only be diagnosed when symptoms persist more than a month after the traumatic event (American Psychiatric Association, 2013). When symptoms similar to PTSD occur within the first month of the trauma, a person may be diagnosed with Acute Stress Disorder.

Myth #3: People who get PTSD are weak

There is no evidence that people who develop PTSD are weaker than those who do not. There are several factors that affect whether someone will get PTSD after experiencing a traumatic event. Research suggests that there may be neurobiological factors that predispose certain people to developing PTSD (Keane, Marshall, & Taft, 2006). Other risk factors include past history of trauma, age at time of the traumatic event, type of trauma, and duration of trauma. Also, people who felt that they were supported by their friends and family were less likely to develop PTSD after a traumatic event.

Myth #4: PTSD isn’t a real thing

Studies on the brain show measurable differences in a person’s brain after they have developed PTSD (Bremner, 2006). This means that PTSD actually changes the way your brain works and how it responds to your environment.

Myth #5: If I force myself to stop thinking about the trauma, it will go away

People often want to avoid thinking about the trauma and avoid anything that could remind them of it as well (Herman, 1997). This avoidance doesn’t stop the experience of pain and can severely limit a person’s life. People living with trauma may begin to socially isolate themselves or stop doing things they used to enjoy. Some survivors may also resort to drugs and/or alcohol to cope with the pain. The most effective way to overcome trauma is to talk about it.

Myth #6: I am going crazy

Many people coping with the aftermath of trauma feel like they are going crazy. Their mind and body may react in unpredictable and uncontrollable ways. It is important to realize that this is normal for anyone who has survived a traumatic event. These reactions are often due to internal and external triggers, which make the memory of the trauma resurface (Tull, 2014). Internal triggers may be anger, fear, memories, or physiological cues like a racing heart or muscle tension. External triggers come from the environment such as people or places that remind you of the event, smells, anniversaries, or noises.

Myth #7: I’m going to feel like this for the rest of my life

Living with trauma is painful and for some people the effects are long lasting. The good news is that some people will recover from trauma over time, especially those who feel that they can rely on friends and family for support. There are also effective therapies out there for treating those who develop PTSD. A new area of research is showing that out of trauma can come posttraumatic growth, which is when trauma gives birth to positive changes (Joseph, 2014). For example, the mothers who lost their children due to drunk driving and formed Mothers Against Drunk Driving (MADD), an organization that aims to stop drunk driving and support victims.

Are you having a hard time finding the information you need? Here are a few good websites and resource pages for mental health concerns. Please feel free to contact me for information on local resources or more in-depth information.

New Year’s resolutions can be for fun, minor improvements or they can be much needed changes in one’s life. In Santa Monica and Los Angeles some of the most popular New Year’s resolutions are:

Finding a soul mate

Losing weight

Improvement in one’s career and income

Quitting smoking

A healthier diet

Better relationships

Traveling

Getting sober

As a clinical psychologist I often hear about goals for the New Year and with it come the questions of “how do I do it”. According to Norcross’ research, only 50% of people state they achieved their New Year’s resolution. It begs the question, what leads to success and what leads to ones failure in achieving goals.

Some factors that lead to success:

Be realistic with your goals and the time needed for change to occur

Divide the process into smaller steps and time intervals

Be compassionate with yourself and how difficult the process of change can be

We all have friends and family that are struggling and could benefit from therapy. I often hear people say “He/she really needs some help”. It can be quite obvious when someone needs additional support, but how can you possibly suggest that someone see a psychologist?

Recommending professional help is a delicate issue. You certainly risk being met with anger and resentment. However, doing nothing can be even more harmful than having to encounter some resistance. When someone you know is showing obvious sign of being in distress you can assume that they have been struggling for quite some time and might actually be desperate for some help and change.

Here are a few pointers that might make your conversation easier:

Listen to their story and how they are doing

Ask some questions and look for signs of hope for change

Ask the person what they have tried to get better

Offer some personal experiences with therapy (if you are willing to disclose)

Ask what kind of change the person is hoping for in life

Recommend therapy as a tool to find support, heal, and grow.

It is scary and might feel inappropriate to suggest to someone to get help. You’ll be surprised by how cared for and understood someone might feel by such a suggestion. People don’t want to feel miserable and often don’t know how to create positive change. With a gentle nudge in the right direction you can have a big impact one someone’s direction in life and you might even be able to save a life!

A cancer diagnosis is often incredibly scary and devastating for the patient and his or her family. Life is no longer the same. How do you cope with it and how do you move forward?

There is a ton of advice about how to cope with cancer and what to do. For example, the Mayo Clinic (2011) lists several things one should do:

Review your goals and priorities

Ask as many questions as possible about your cancer and prognosis

Educate yourself

Try to maintain your normal lifestyle

Talk to other people with cancer

Fight stigmas

Look into insurance options

Ask for help and reach out to loved ones

Develop your own coping strategy

Practice relaxation techniques

Share your feelings honestly with family, friends, a spiritual adviser or a counselor

Keep a journal to help organize your thoughts

When faced with a difficult decision, list the pros and cons for each choice

Find a source of spiritual support

Set aside time to be alone

Remain involved with work and leisure activities as much as you can

These are all great ideas, but it is hard enough to do these things when one isn’t fighting for his/her life. How in the midst of this journey, do you find your own way to live life? There is hardly enough time to educate yourself, make life changing decisions and process all of you emotions.

Psychotherapy can be a big help by providing a safe space to help you find your way of coping, making the right decisions for you and your family, and to get support. Ideally, it is the one place where you aren’t told what to do and how to fight this war. Here you will be met with warmth and compassion; and you will have lots of space for your own process.

There are many different kinds of traumas one can experience. There are the one time traumas and the multiple or cumulative traumas. Single event traumas consist of stranger physical/sexual assault, natural disasters, large scale accidents, house fires, medical traumas, accidents, rape, sexual assault, terrorism. The multiple and cumulative traumas are partner battery and domestic violence, torture, war, prolonged emotional abuse, neglect, and first responder vicarious traumas.

Many of us experience a life changing trauma at one point or another and it can be difficult to face it alone. There are several factors that contribute to how a person experiences the traumatic event. The number one protective factor is often social support. Positive social support can make a huge impact on someone’s resiliency and ability to cope with traumatic experiences.

FACTORS THAT CONTRIBUTE TO A MORE COMPLICATED PROGNOSIS

Stigma

Is alone

Receives blame

If there was a breakdown of trust

If the trauma involved another individual

If the trauma was unpredictable and uncontrollable

If there was physical injury and a high degree of loss and threat

If the trauma was a sexual trauma

PTSD has received a lot of publicity through our veteran population and there seems to be some stigma a about it. There is the misconception that someone with post-traumatic stress symptoms is not resilient and incapable of handling the events. This is not true. Post traumatic symptoms are simply a physiological an emotional response to extreme circumstances to let us know that there is a threat and that something is out of balance.

If you are struggling with any of these symptoms seeking the help from a psychologist can help your healing process and restore some balance in your life.

WHAT TO LOOK FOR IN A THERAPIST

Seeking help after a traumatic event can be very difficult. One is already fearful and struggling with feelings of shame and vulnerability, therefore it is important to find someone you feel comfortable with.

Look for a therapist you feel safe with, who you feel understands you.

Look for a therapist who is well trained. There are many professionals that claim to have some experience with trauma yet few actually have specialty training.

Look for a therapist you can have a trusting relationship with. The therapeutic relationship is one of the most important factors in the healing and growth process.

WHAT YOU CAN EXPECT FROM THERAPY

Therapy is a very powerful tool that can change your life; however, it takes time and can be a slow and painful process. With time you will notice a decrease in your symptoms, feel more at ease, gain insight about your triggers and learn more about yourself.